Journal of orthopaedic trauma · 2025
What is the rate and timing of salvage surgery after operative treatment of talus fractures?
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
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Roddy Erika, Hannay William, Khilfeh Bilal, Newell Kira, Dalstrom David, Sangeorzan Bruce, Benirschke Stephen, Firoozabadi Reza
Аннотация
OBJECTIVES: To report on the short-term, mid-term, and long-term rates of salvage treatment after operative treatment of talus fractures.
DESIGN: Retrospective cohort study.
SETTING: Level one trauma center.
PATIENT SELECTION CRITERIA: All patients with a talus fracture (AO/OTA 81.1-81.3) treated surgically at a level one trauma center between 2008 and 2018 were eligible for inclusion.
OUTCOME MEASURES AND COMPARISONS: The primary outcome was conversion to salvage treatment, defined as conversion to arthroplasty, arthrodesis, or amputation.
RESULTS: A total of 343 patients with operatively treated talus fractures were identified. One hundred and twenty eight patients were reached by telephone for long-term follow-up. Two hundred and twenty two (65%) were men. The mean age was 35 (SD 10, range 14-70). There were 195 (57%) talar neck fractures, 113 talar body fractures, 5 talar head fractures, and 30 lateral process fractures. The mean duration of follow-up was 5 years. Twenty-four patients (7%) underwent 24 salvage procedures. The rate of salvage was 1% (95% CI 0-3%) at 1 year, 3% (95% CI 1-6%) at 2 years, 10% (95% CI 6-15%) at 5 years, 13% (95% 9-20%) at 10 years, and 15% (10-22%) at 16 years. All salvage procedures occurred within 11 years, and 80% occurred within 5 years of injury. In multivariate cox analysis, the presence of higher Hawkins type as well as the presence of AVN with collapse (HR 4.67 (95% CI 1.82, 11.99, p=0.001)) and arthritis (HR 5.70 (95% CI 1.25, 25.78, p=0.024) remained predictive of conversion to salvage treatment.
CONCLUSIONS: The rate of salvage surgery was 15% at 16 years after operative treatment of talus fractures. The highest risk of conversion to salvage treatment was within the first 5 years. The presence of a neck or body fracture, higher Hawkins classification, development of AVN with collapse, and arthritis were associated with increased risk of conversion to salvage treatment.
DESIGN: Retrospective cohort study.
SETTING: Level one trauma center.
PATIENT SELECTION CRITERIA: All patients with a talus fracture (AO/OTA 81.1-81.3) treated surgically at a level one trauma center between 2008 and 2018 were eligible for inclusion.
OUTCOME MEASURES AND COMPARISONS: The primary outcome was conversion to salvage treatment, defined as conversion to arthroplasty, arthrodesis, or amputation.
RESULTS: A total of 343 patients with operatively treated talus fractures were identified. One hundred and twenty eight patients were reached by telephone for long-term follow-up. Two hundred and twenty two (65%) were men. The mean age was 35 (SD 10, range 14-70). There were 195 (57%) talar neck fractures, 113 talar body fractures, 5 talar head fractures, and 30 lateral process fractures. The mean duration of follow-up was 5 years. Twenty-four patients (7%) underwent 24 salvage procedures. The rate of salvage was 1% (95% CI 0-3%) at 1 year, 3% (95% CI 1-6%) at 2 years, 10% (95% CI 6-15%) at 5 years, 13% (95% 9-20%) at 10 years, and 15% (10-22%) at 16 years. All salvage procedures occurred within 11 years, and 80% occurred within 5 years of injury. In multivariate cox analysis, the presence of higher Hawkins type as well as the presence of AVN with collapse (HR 4.67 (95% CI 1.82, 11.99, p=0.001)) and arthritis (HR 5.70 (95% CI 1.25, 25.78, p=0.024) remained predictive of conversion to salvage treatment.
CONCLUSIONS: The rate of salvage surgery was 15% at 16 years after operative treatment of talus fractures. The highest risk of conversion to salvage treatment was within the first 5 years. The presence of a neck or body fracture, higher Hawkins classification, development of AVN with collapse, and arthritis were associated with increased risk of conversion to salvage treatment.